By Agvina Dicom
NOV 12, 2020: The latest news that company giants Pfizer and BioNTech have successfully created a Covid-19 vaccine (BNT 162b2) that is supposedly 90% effective, non-exhibiting of serious safety concerns and ethically non-controversial has got the whole world excited but in the race to be hailed as ‘number one’ in beating the Covid-19 crisis, are scientists and pharmaceutical firms truly practicing ethical standards without down-playing the side effects involved?
For many concerned Malaysians and Catholics, could there possibly be another option to consider or is vaccine the one and only solution?
Aborted fetal cells and mRNA
The news of some vaccines being made from aborted fetal cells like that of the vaccine by AstraZeneca which uses HEK-293 (fetal kidney cells) and Janssen Research & Development’s vaccine which uses PER.C6 (fetal retinal cells) came as a shock to many especially the Roman Catholic Church.
In the late 1800s, animal cells were originally used to develop vaccines. The first vaccine made was for smallpox in 1796, which was harvested from calves infected with cowpox. However some animal cell cultures were found to be carrying other viruses though mostly harmless to humans but still raised concerns. Some viruses also did not grow well on animal cell cultures but thrived on human cell based mediums. This lead scientists to conclude that human fetal cells made perfect culture mediums for vaccines.
Vaccines are actually attenuated (neutralized) or dead viruses which are cultivated in lab cell cultures. These cell cultures are made from surgically-aborted fetuses or from fetuses that were infected with a virus prior to an abortion or miscarriage. The first fetal cell used in a vaccine was the WI-38 (fetal lung cell) derived by Leonard Hayflick from the Wistar Institute of the University of Pennsylvania, Philadelphia. It was used in vaccines for measles, mumps, rabies and rubella.
Pfizer and BioNTech however have claimed that their vaccine does not use fetal cells but instead uses a non-cellular based technology. Apparently the vaccine is developed in test tubes using viral RNA and enzymes that create what is called mRNA which is injected into a recipient. This mRNA prompts the recipient cells to produce proteins that stimulate an immune response. With rapid mutations in the protein spikes of the Cv19 virus, many scientists are speculating on the mRNA based vaccine’s effectiveness in actually triggering a sufficient immune response and in providing long term immunity without any future manifestations of side effects.
What is Convalescent Plasma Therapy?
The Covid-19 Convalescent Plasma (CCP) is a blood component from Covid-19 recovered patients that contains high titers of antibodies that specifically recognize the SARS-CoV-2 antigen and is found to exert an anti-viral effect by suppressing the virus replication process. These plasma antibodies are then transfused to susceptible individuals to fight on-going infections or to build up immunity.
Convalescent Plasma therapy is known as passive immunization as opposed to vaccination which is termed as active immunization. The working principles of Convalescent Plasma is similar to other forms of passive immunizations such as an in-utero fetus that receives antibodies from maternal blood or an infant that receives antibodies by feeding on breast milk.
The use of Convalescent Plasma as treatment and disease prevention can be dated back to as early as 1894 where a serious outbreak of Diphtheria (a life-threatening disease caused by the bacteria Corynebacterium diphtheria) was treated with antibodies from horse serum. The use of human blood-derived antibodies was first noted in 1916 and 1918 during the outbreaks of polio and the Spanish Influenza A respectively. This paved way for the use of Convalescent Plasma throughout history as a treatment and prophylaxis for diseases such as measles, rabies, hepatitis and chicken pox.
To date, Convalescent Plasma therapy was reported to be used during the SARS and Influenza A (H1N1) outbreaks in 2003 and 2009, and in the 2013 Ebola epidemic. The use of plasma antibodies has been deemed as a trustworthy counter measure in treating victims of newly emerging diseases and in preventing the spread of contagious infections especially in the absence of a viable vaccine or in the presence of a vaccine that is suddenly ineffective or with problematic side effects.
Convalescent Plasma Therapy vs Vaccines
On 23rd August 2020, the United States FDA issued an Emergency Use Authorization (EUA) which allowed the use of Convalescent Plasma to treat Covid-19 patients who had severe symptoms or were in critical condition. Treating physicians found that when Convalescent Plasma was given within 1-3 days of positive Covid-19 infection, the patients not only recovered better and faster but also avoided the need of having to be put on oxygen supplementation or ventilators. The results also showed extremely low number of patients suffered adverse effects like fevers, allergic reactions and transfusion related organ malfunction after treatment. Similar clinical findings were also reported by China, Italy and Pakistan.
Vaccines can also render undesirable side effects ranging from fevers, muscular pains and allergic reactions to brain inflammations and seizures which may lead to death. The only difference is that side effects from Convalescent Plasma therapy can be seen as early as 4 hours after treatment, giving an early start in resolving the progression of the side effects but vaccine induced side effects may take longer to manifest depending on the recipient’s immune system and some adverse effects may only manifest after a recipient’s exposure to a viral infection.
A vaccine that is safe for use usually takes about 2-3 production years but pharmaceutical firms like Sinopharm, Sinovac, Cansino Biologics, Pfizer and BioNTech have all announced that they have manufactured vaccine candidates hardly within 10 months of research with some vaccines still in final stages of Phase 3 clinical trials. Other pharmaceuticals like UK’s AstraZeneca and US based Johnson & Johnson have temporarily halted vaccination trials after some of the recipients became ill.
Due to this, many physicians are turning to Convalescent Plasma therapy to save Covid-19 patients, taking into caution to begin the antibody treatment at the early infection stage so as to not provoke an aggressive inflammatory response known as the Covid-19 Cytokine Storm. Excessive release of cytokines (inflammatory proteins) can cause severe lung injury and multi-organ failure.
The favourable results of plasma antibodies as a reliable prevention in disease transmission should be highly considered since scientists have reported of Covid-19 survivors showing a rapid decline in protective antibodies with symptomatic patients depleting antibodies after 5-6 months of recovery and asymptomatic patients showing antibody reduction within just 3 months.
With all that said, now it just leaves the question of what the Malaysian government decides to do. Will we also be caught up in the hype of desperately trying to obtain the latest vaccine which we are not truly certain of its effectiveness, contraindications or ethical standards? Or will the government consider of looking into alternative options like Convalescent Plasma with the aid of MOH and IMR?
Will Malaysians and Catholics be able to access options that will not put them in an ethical dilemma or in fear of health concerns? Truly we have much to ponder about before making a rightful decision since our lives and the lives of our children may depend upon it.
Church leaders should pursue this so as to make sure we get safe and ethical options.
Agvina Dicom is a Biomedical Technologist & Phlebotomist with a private medical laboratory in KL. She graduated in Biomedical Science from UKM in 2003 and has been in the field of Biomedicine and Laboratory technology for almost 17 years.